Despite it being the most common mental health condition in Australia, with one in three women affected, there are plenty of misconceptions around anxiety.

Sufferers are typically thought to be paralysed by panic attacks and withdrawn from the world, but this isn’t always the case. While it’s not an official diagnosis, “high-functioning” anxiety is something many people identify with.

SANE Australia Psychologist, Suzanne Leckie, says that anxiety can affect different people in different ways and that high-functioning anxiety is a alternative manifestation of the condition, rather than an alternative condition.

“Sometimes people with anxiety inadvertently shrink their own world by avoiding activities that trigger their anxiety. Other times anxiety can motivate people to try harder across all aspects of their lives.”

She says that those living with high-functioning anxiety can be perceived by others as achievement-oriented, perfectionistic and highly motivated.

“Their own reality is likely to be one of racing thoughts, restless bodies and a sense that they are never doing enough.”

The usual symptoms of anxiety are present for those living with high-functioning anxiety, including catastrophic thinking, excessive worry and irritability.

“The difference with high-functioning anxiety is that people experiencing this may feel the desire to achieve more as a way to manage their fears and doubts,” Leckie says.

If this sounds like you, here are some of the other signs you might be struggling.

1. People describe you as a “Type A” perfectionist

At work, at home, in relationships or in the gym – you strive for perfection in everything you do. These unrealistic expectations of yourself is often coupled with a catastrophic fear of not meeting them. You often have an ‘all or nothing’ mentality – ‘if I’m not the best, then I’m the worst’.

2. You exhibit controlling patterns

This “perfectionism” can manifest in controlling habits and strict routines, but it’s really a way to make you feel like you’re more in charge of your life. Missing a single workout or using the wrong colour highlighter can send you spiralling.

3. You’re constantly busy

Your to-do list is a kilometre long and your weekends are packed with plans but you love it, right? You always joke about how you need to be busy to feel happy, right? But constantly having something to do keeps your mind off what will happen when you finally stop and you’re alone with your own thoughts.

4. You’re not sleeping well

All that tossing and turning during the night can be a true reflection of what’s going on instead your head. The anxiety you’ve internalised throughout the day may come out in the form of sleep disturbance.

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5. You have aches, pains, repetitive habits or ticks

There can often be physical manifestations of your mental state, like that constant knot in your stomach or unexplained neck pain. Continuously biting your nails, chewing your lip, tapping your foot or cracking your knuckles could be another sign your suppressed anxiety is shining through.

6. People have a hard time reading you

You’ve been described as stoic and unemotional but you know that couldn’t be further from the truth. By trying to keep your anxiety to yourself, you often compartmentalise your emotions in an attempt to think logically and rationally.

7. You have a crippling fear of letting other people down

Obsessive and intrusive negative self-talk is a big indication of high-functioning anxiety, and the constant concern that you’re disappointing those around you is common.

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8. “No” isn’t part of your vocabulary

The dread of letting people down, your impossibly high, self-imposed standards and crippling FOMO leads you to taking on more than you can possibly handle. You never say no to work projects, social plans or helping out a pal, despite being stretched to breaking point.

So if this sounds like you, what can you do?

“Learning mindfulness strategies can be very helpful for those living with high-functioning anxiety as the strategies can help to anchor us in the present rather than entertaining future-based worst-case scenarios,” Leckie suggests.

“Cognitive-behavioural therapy can also help people develop the skills to challenge irrational thinking, such as perfectionism, which can fuel the anxiety.”

For information, support and guidance from mental health professionals, contact the SANE Help Centre on 1800 187 263 or email [email protected] from 10am-10pm AEST. The SANE Online Forums also provide a safe, free and anonymous online platform offering connection and support.

This piece by Lauren Williamson was first seen on ‘Women’s Health’, 6 December 2017.